Nursing is a practice profession that has long been regarded with esteem and trust by the public. The education of nurses is a process that has evolved over the last 150 years from apprenticeship-based training to an academic program grounded in the arts and sciences. Nurses must successfully learn a rigorous academic curriculum, demonstrate application of knowledge and skills in the clinical setting, and pass a national licensure exam to practice their profession. Boards of nursing are legislated the responsibility of protecting the public by assuring that nurses who practice in their state are safe, competent, and ethical practitioners. This responsibility is implemented through legislated nurse practice acts and administrative rules that define and regulate nursing practice and nursing education.The purpose of this qualitative research study was to identify and articulate best practices that support an increase in National Council Licensure Exam-Registered Nurse (NCLEX-RN®) passing percentages of graduates from nursing programs in Iowa. Program improvement documents submitted by nursing education programs demonstrating pass rates below the acceptable benchmark set by the Iowa Board of Nursing were analyzed for organization, structure, and content. Review of the nursing literature, including evidence-based practices and scholarly works, helped to inform the research. Exploration of regulatory practices and related outcomes provided another lens and source of data from which to view practices within Iowa. Complexity theory guided and informed this evaluation research study and was applied by incorporating Daniel L. Stufflebeam’s (2003) Context, Input, Process, and Product (CIPP) model as a framework for content analysis of documents.This study has provided greater understanding of how nursing programs responded to the Iowa Board of Nursing policy mandate. The knowledge generated supports policy recommendations for improving the percentage of graduates passing the licensure examination within six months of graduation from an approved nursing program. Recommendations for policy, education, and future research are presented.
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